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Insulin pen
Using insulin pens can be very convenient. Slightly more costly than insulin in vial form and syringes, but well worth it to give you confidence, or if you have visual impairments. They are less prone to dosage error, too. They can be a big help if you are new to diabetes and a bit unsure about things. See also injecting insulin. Refillable vs. disposable Insulin pens come in 2 basic styles: prefilled which you discard after the insulin is used, or refillable. Refillable pens are much like fountain pens; insulin cartridges are inserted and changed when empty. Refillable pens are usually cheaper in the long run, and also more accurate -- the plunger mechanism on the disposable pens is a bit flimsy, and can give inaccurate doses by half a unit or so. Pens vs. vials Availability Before you decide to use a pen or not, you must first determine if the insulin you are using comes in one. Lente, Ultralente, and PZI insulins do not, as they are not able to be properly resuspended for injecting in pen form. In Europe, things may be the other way round -- many insulins come only in pen form there, and if you wish to use syringes for their greater precision, you must use them with pen prefill cartridges. Cost In the case where the insulin is expensive and expires quickly, as with Lantus, you may find yourself throwing away a lot of expired insulin -- it can then be cheaper to use pens, with their small 3ml cartridges. Precision Next you need to determine the pet's average insulin needs, and how precise the dose must be. Most pens inject full units of insulin only; some are designed to inject a minimum of two units with 1 unit increments. Smaller pets often require insulin doses that include half units or even smaller increments. If you decide on a refillable pen, keep in mind that Lilly insulin cartridges don't fit Novo's pens, and so on. The Novopen 3 Demi and Novopen Junior (refillable) pens seem to be the only ones on the market allowing doses that include half-units, and they only work with Novo insulins. Pen usage * If you need more precise doses than a pen provides, you must use a syringe. Many penfill cartridges can be used with syringes, just like small vials, but often require that you inject a similar volume of air into the cartridge every time you draw insulin. Once you've used a syringe on a cartridge, that cartridge should not be reinserted into a pen. * Most pens are now designed to hold 300ml of insulin and do not need refrigeration after being started. Some insulins don't keep as well as they do in vial form; average time from first use to discarding/changing cartridges is as low as 14 days--even though there may be plenty of insulin left. Newer insulin analogs like Levemir and Lantus last about a month without refrigeration in their pens. * All "cloudy" (NPH, NPH Mixes, Analog Mixes) insulins available in pen form need to be re-suspended before use, just like their vialed counterparts. See the manufacturer's instructions regarding proper re-suspension technique for your brand of pen/type of insulin. Needles Along with the pens, you will need to purchase disposable screw-on pen needles. They come in lengths ranging from the standard 1/2' to the "ultra short" 3/16" length. Gauges are from 29-31. Not all manufacturer's pen needles fit all pens. Novo's NovoFine pen needles fit only Novo's pens, etc. These needles can do double duty as lancets after being used, though, so consider their cost versus that of syringes AND lancets. Ultra-Fine pen needles fitting all US-available pens are available in the following sizes/gauges in the US: *29g, 1/2" (The "standard"; this is the usual length and gauge seen on syringes), *31g 5/16" (short), *31g 3/16" (classed as mini--shorter than "short"). Length of needle for a cat or dog is very much an individual preference. The injection technique, thickness of skin and fat layer, and injection site details of each pet may require a particular length, or may be more flexible. Once you find a length that works for your pet, it may be more difficult to change than you think. External links *Free Using Insulin Pens Video, plus US free prefilled pen offer *Compare insulin pens and other supplies here. *This Diabetes Health Guide compares all currently marketed (US) insulin pens--refillable and disposable. *Diabetes UK's list of available insulin pens. *BD Diabetes Category:InsulinsCategory:SuppliesCategory:Tips